1 . Shenzhen in Guangdong province has become the first city in China to allow specialist nurses to prescribe (开药方) selected drugs and order tests, in a move that is expected to increase efficiencies in the healthcare system and reduce the patient-load burden on physicians.

Under a new rule in October that took effect in January, eligible nurses will be permitted to order examinations, treatments considering their expert skills and knowledge of specialist nursing or community healthcare. Their prescriptions must be based on existing diagnoses (诊断) made by physicians.

To become a nursing specialist, applicants should have a bachelor’s degree in nursing, five years of working experience, obtained an advanced nursing qualification and have attended a months-long specialist training program and passed a final test.

“Medical institutions must review inappropriate prescriptions given by nurses,” said the regulation. “Nursing specialists who are found to have given three or more improper prescriptions will have their prescribing power stopped for three to six months and will have to undergo retraining before regaining the authorization,” it added.

“Considering the difference in professional positioning, medical education background and work experience between physicians and nurses, it is necessary to fully analyze the necessity and practicability of the nurses’ prescriptive authority,” the commission said.

Zhou Wensi has a bachelor’s degree in nursing and is now a specialist nurse in periodontitis (牙周炎) , or gum disease, at Shenzhen Stomatology Hospital in the city’s Pingshan district.

“Our hospital has not begun allowing us to prescribe. If the rule goes into effect in the future, we’ll likely be able to directly prescribe mouthwash, anti-inflammatory drugs and painkillers to patients,” she said.

   However, she also noted that most patients visiting the hospital are in need of treatment delivered by doctors with assistance from nurses like her, so the new regulation is not expected to have a major impact.

3 . When Arvin Kuipers, who graduated from Beijing University of Chinese Medicine in 2017 and loves Chinese culture, asks his patients to stick out their tongue so he can diagnose(诊断) their illness, many are confused.

Kuipers, 30, practicing Traditional Chinese Medicine (TCM) in Amsterdam in the Netherlands, said, “In TCM I need to do face and tongue diagnosis. That’s strange for people in my country.” One elderly woman had been visiting him occasionally for advice, but her first experience with TCM surprised her. She had never experienced acupuncture (针灸) or any other TCM treatment. “She came in, and I examined her face and tongue,” said Kuipers. “I told the patient her kidneys were not doing well and that she wasn’t getting proper sleep.” The woman was shocked by his insight and asked if he had been spying on her. “Actually, it was easy to diagnose her condition when I saw the dark rings under her eyes. Her energy levels were also very low at the time.”

Kuipers opened his TCM clinic in September. Most of his work involves performing acupuncture, cupping as well as tuina — a TCM massage that patients in the West like the most, he said. In some cases he also gave his patients traditional herbal medicines.

Kuipers usually makes a cup of Chinese tea to calm his patients if they are nervous about the acupuncture needles. He also explains to them the meridian (经络) system, which is a central concept of TCM, yin and yang, and other concepts. “In TCM, good health requires balanced yin and yang, so practitioners not only pay attention to a patient’s illness, but also to his or her overall physical condition,” said Kuipers. “TCM is also a different culture and offers a new perspective, instead of being a curing method.”

As of early April, Kuipers has treated more than 200 patients, many of whom come to his clinic every week. “TCM does work, and works well. My patients really feel better with it, so I value it, and when my patients feel better I also feel better.”

If you see someone collapse (失去意识), perhaps as a result of a heart attack, what can you do while you wait for an ambulance?

Chen Wenqiaochu set    1    example when he was 14. He performed CPR (心肺复苏术) on a cleaner at his school,    2    (save) the man’s life in 2013. Chen showed that knowing how to perform CPR can be    3    (benefit). According to medical experts, there is a “golden period”, the first four minutes of a heart attack,    4    CPR is most effective in saving the person’s life.

On Aug 24, a joint guideline    5    (issue) by the Ministry of Education and Red Cross Society of China. It asked all public schools nationwide    6    (provide) first-aid courses, including CPR training, as part of health education.    7    (fortunately), less than 1 percent of Chinese adults have mastered the skill of CPR, while many have never heard of    8    .

Nowadays, many countries have attached importance    9    the popularization of first-aid training, including CPR. In 1966, the American Heart Association requested that US police officers, firefighters, secondary school teachers and college instructors receive CPR training. Now in    10    (German), every citizen must be trained before getting their driver’s license, which means about 80 percent of the country has received first-aid training.

10 . This year’s flu season is shaping up to be a bad one. The new type of flu virus is more severe than most. In addition many people find the vaccine this year to be less effective, and others are wondering if they should still get a flu shot. The answer is yes.

Each summer, scientists try to make a best guess on which variants (变体) are going to be more common in the coming year. They look at data from other countries, and then they make the shot to match.

Sometimes a vaccine doesn’t work well because some variants change too much. That’s why in any year, even when you’re vaccinated, you can get the flu. The shot is about reducing your risk, not getting rid of it.

“Less” and “more” effective are relative terms, so we need to focus more on absolute risks. In 2010, researchers published an in-depth analysis of all flu shot studies. They showed that when a vaccine was considered effective, 1.2% of vaccinated people had the flu, while 3.9% of unvaccinated people had the flu. That’s an absolute risk reduction (ARR) of 2.7 percentage points. In studies in which the flu shot was considered ineffective, 1.1% of vaccinated people had the flu compared with 2.4% of unvaccinated people. The ARR was 1.3% points.

Let’s say this year’s flu vaccine is even worse than we think. Maybe the ARR will be as low as 1 percentage point. That’s still not that bad. Given the millions who are likely to suffer from flu and the thousands of deaths each year, this is a big payoff in public health. The Centers for Disease Control and Prevention (CDC) says that 9 million to 36 million people become ill with the flu each year in the United States. Somewhere between 140,000 and 710,000 of them require hospitalization, and 12,000 to 56,000 die each year.

No vaccine is perfectly protective in any year. But to minimize your chances of illness, yes, you should still get the flu shot this year, and any year.